Provider Demographics
NPI:1710087366
Name:FRIMTZIS, BRUCE G (OD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:G
Last Name:FRIMTZIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 E VALLEY PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-2317
Mailing Address - Country:US
Mailing Address - Phone:760-432-6331
Mailing Address - Fax:760-432-6319
Practice Address - Street 1:1320 E VALLEY PKWY STE D
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-2317
Practice Address - Country:US
Practice Address - Phone:760-432-6331
Practice Address - Fax:760-432-6319
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT8466T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0084660Medicaid